Assessing Barriers to Implement Birth Kangaroo Care in Kentucky Birthing Hospitals.

INTRODUCTION: Kentucky continues to have one of the lowest state breastfeeding rates in the country. In 2014, the majority of the birthing hospitals in Kentucky implemented a practice change to the healthcare model known as Birth Kangaroo Care (BKC) as an effort to increase breastfeeding initiation. The goal of this study was to identify current practices and barriers to implementing BKC. METHODS: An evaluation/surveillance study that incorporated an Internet survey to collect information about the practices and policies of BKC in birthing hospitals in Kentucky was completed. FINDINGS: The response rate was 54% (n = 25). The birthing hospitals responders to the survey (84%) reported that a BKC policy was established after the educational intervention. Data identified two perceived barriers regarding uninterrupted BKC. One barrier was the interruption by family members to hold the newborn, and the second was a delay in BKC for medical evaluations of the baby by staff members. CONCLUSION: Breastfeeding rates after implementation of the BKC policy in Kentucky birthing hospitals showed a statistically significant (p = .02) improvement of "ever breastfed" infants.

Applying the plan-do-study-act model to increase the use of kangaroo care.

AIM: To increase the rate of participation in kangaroo care within a level III neonatal intensive care unit. BACKGROUND: Preterm birth typically results in initial separation of mother and infant which may disrupt the bonding process. Nurses within the neonatal intensive care unit can introduce strategies that will assist parents in overcoming fears and developing relationships with their infants. Kangaroo care is a method of skin-to-skin holding that has been shown to enhance the mother-infant relationship while also improving infant outcomes. However, kangaroo care has been used inconsistently within neonatal intensive care unit settings. METHODS: The Plan-Do-Study-Act Model was used as a framework for this project. Plan-Do-Study-Act Model uses four cyclical steps for continuous quality improvement. Based upon Plan-Do-Study-Act Model, education was planned, surveys were developed and strategies implemented to overcome barriers. RESULTS: Four months post-implementation, the use of kangaroo care increased by 31%. CONCLUSIONS: Staff surveys demonstrated a decrease in the perceived barriers to kangaroo care as well as an increase in kangaroo care. Application of Plan-Do-Study-Act Model was successful in meeting the goal of increasing the use of kangaroo care. IMPLICATIONS FOR NURSING MANAGEMENT: The use of the Plan-Do-Study-Act Model framework encourages learning, reflection and validation throughout implementation. Plan-Do-Study-Act Model is a strategy that can promote the effective use of innovative practices in nursing.